POS0772 ´´EPIDEMIOLOGY OF JUVENILE IDIOPATHIC ARTHRITIS IN ARGENTINA: A RETROSPECTIVE STUDY´´
Authors: D. Vidal, J. Giuponni, L. Guerini, R. C. Larroulet, M. S. Galindo, J. Farfan, M. Arispe, I. Vilca, L. Franco, V. Ochoa Y Gomez, M. Marcantoni, V. Deves, F. Zunino Pradier, M. E. Rama, G. Yesuron, C. Torres Walsh, I. Pintos, V. Duarte, G. Espada
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The term juvenile idiopathic arthritis (JIA) represents a heterogeneous group of disorders, all manifesting joint inflammation, but with different clinical phenotypes, disease course, and outcomes [1,2]. In Argentina, information about patients with JIA is scarce. In our country, different factors such as the diversity of sociodemographic conditions and the disparities in the access to health care, could influence the JIA subtypes prevalence and prognosis of these patients. <h3>Objectives</h3> Describe the sociodemographic and clinical characteristics of patients with different subtypes of JIA. <h3>Methods</h3> Descriptive, retrospective, chart review and multicenter study. Patients were included with a diagnosis of JIA, according to ILAR criteria (2001) and onset of symptoms ≤ 16 years, diagnosis within the last 3 years and with at least 12 months of follow-up since diagnosis by the same physician or treating team. Sociodemographic variables, clinical variables prior to diagnosis by the pediatric rheumatologist, time to specialist consultation, treatments prior to diagnosis and variables at the time of diagnosis by the specialist were recorded: JIA subtype; serological, articular, ocular, and systemic manifestations; associated complications and treatments given. <h3>Results</h3> 320 patients from 17 specialized care centers in Argentina (11 public and 6 private) were included. The mean age at symptom onset was 6.9 years (SD 4.09) and 65.6% of the patients were girls. 94.4% of the patients were in school according to their chronological age. 37.2% and 36.9% of the patients belonged to lower-middle socio-economic strata respectively as measured by the Graffar scale. 96.9% had urban residence and the place of residence in decreasing order were: Province of Buenos Aires, Gran Buenos Aires, CABA, Córdoba, Santa Fe, Jujuy; Salta, Tucumán, Entre Ríos, Catamarca, Chubut, Río Negro, Santiago del Estero, San Juan, Formosa, Chaco, La Pampa, La Rioja, Mendoza, Neuquén and Santa Cruz. 49.1% had private medical insurance and 41.6% public. The mean education (in years) of the parents was 13.6 years (SD 4.16). 54.5% of the cases the first professional visited was the orthopedist. 57.% of patients had received previous treatment: 90.9% non-steroidal anti-inflammatory drugs (NSAIDs) and 5.11% corticosteroids. At diagnosis, JIA subtypes were represented by persistent oligoarthritis (37.8%); polyarthritis FR -(20%); systemic (15%); polyarthritis FR +(12.1%); enthesis-related (6.8%); extended oligoarthritis (2.5%); psoriatic (1.8%) and undifferentiated (0.3%). The median delay by subtype was persistent oligoarthritis (3.00[2.00,4.50]); polyarthritis FR -(3.00[2.00,6.00]); systemic (1.00[100,2.00]); polyarthritis FR +(3. 00 [2.00,6.00]); enthesis-related (7.00 [3.25,12.0]); extended oligoarthritis (3.5 [1.00,4.25]); psoriatic (11.5 [4.75,13.8]) and undifferentiated (1.00 [1.00,1.00]). Articular and serological manifestations were the most frequent. Ocular involvement (12.5%) was more frequent in the oligoarticular subtype. Macrophage activation syndrome was observed in the systemic subtype (2%) and FR - polyarthritis (1.5%). The most used treatments were NSAIDs, cDMARDs, with methotrexate being the first choice. Patients belonging to the systemic (18.7%) and FR+ polyarthritis (5.0%) subtypes were treated with cDMARDs (Anti TNF and IL6 inhibitors). <h3>Conclusion</h3> This is the first national multicenter study of patients with JIA, and the results provide data that should be prioritized, such as shortening the time to specialist consultation. The comprehensive approach to children with JIA should be coordinated by pediatric rheumatologists and supported by a multi- and interdisciplinary team. <h3>Reference</h3> [1]Garay S., et.al. Rheumatol Int 2018 Apr;38(Suppl 1):51-58. 2- Ravelli A, et.al. Lancet 2007; 369: 767–78. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Daniela Vidal Grant/research support from: Novartis Argentina, Judith Giuponni Grant/research support from: Novartis Argentina, Lorena Guerini Grant/research support from: Novartis Argentina, Romina Cecilia Larroulet Grant/research support from: Novartis Argentina, María Susana Galindo Grant/research support from: Novartis Argentina, Javier Farfan Grant/research support from: Novartis Argentina, María Arispe Grant/research support from: Novartis Argentina, Iris Vilca Grant/research support from: Novartis Argentina, Lorena Franco Grant/research support from: Novartis Argentina, Verónica Ochoa y Gomez Grant/research support from: Novartis Argentina, María Marcantoni Grant/research support from: Novartis Argentina, Vanessa Deves Grant/research support from: Novartis Argentina, Fernando Zunino Pradier Grant/research support from: Novartis Argentina, Maria Elena Rama Grant/research support from: Novartis Argentina, Gabriela Yesuron Grant/research support from: Novartis Argentina, Carolina Torres Walsh Grant/research support from: Novartis Argentina, Ingrid Pintos Grant/research support from: Novartis Argentina, Vanesa Duarte Employee of: Novartis Argentina, Graciela Espada Grant/research support from: Novartis Argentina.